PART III. MEDICARE SUPPLEMENT POLICIES

 

Attorney General Opinions

 

  Section 431:10A-601 applied to all parts of article 10A ifthe category of policy under consideration included family coverage, as definedin §431:10A-103.  Att. Gen. Op. 97-10.

 

§431:10A-301  Definitions.  For thepurposes of this part:

"Applicant" means:

(1)  In the case of an individual medicare supplementpolicy, the person who seeks to contract for insurance benefits, and

(2)  In the case of a group medicare supplementpolicy, the proposed certificate holder.

"Certificate" means any certificatedelivered or issued for delivery in this State under a group medicaresupplement policy.

"Certificate form" means the form onwhich the certificate is delivered or issued for delivery by the issuer.

"Issuer" includes insurancecompanies, fraternal benefit societies, health care service plans, healthmaintenance organizations, and any other entity delivering or issuing fordelivery in this State medicare supplement policies or certificates.

"Medicare" means the Health Insurancefor the Aged Act, Title XVIII of the Social Security Amendments of 1965, asthen constituted or later amended.

"Medicare supplement policy" means agroup or individual policy of accident and health or sickness insurance or asubscriber contract of hospital and medical service associations or healthmaintenance organizations, other than a policy issued pursuant to a contractunder section 1876 of the federal Social Security Act (42 U.S.C. section 1395et seq.), or an issued policy under a demonstration project specified in 42U.S.C. section 1395ss(g)(1), which is advertised, marketed, or designedprimarily as a supplement to reimbursements under medicare for the hospital,medical, or surgical expenses of persons eligible for medicare.

"Policy form" means the form on whichthe policy is delivered or issued for delivery by the issuer. [L 1987, c 347,pt of §2; am L 1989, c 195, §25; am L 1990, c 84, §1; am L 1992, c 195, §1; amL 1996, c 28, §1; am L 2003, c 212, §78]